The role of stereotactic radiosurgery for treatment of
intracranial lesions is well established.Its use for the treatment of spinal
lesions has been limited by the availability of effective target-immobilizing
devices. Conventional external beam radiotherapy lacks the precsion to allow
delivery of large doses of radiation near radiosensitive structures such as
spinal cord

Aim:

The Cyberknife
is an image-guided frameless stereotactic radiosurgery system that allows for
the radiosurgical treatment of spinal lesions. This study evaulted the
feasibility and effectiveness of spinal lesions with Cyberknife.

Methods:

In this prospective cohort
evaluation of a spine radiosurgery technique,24 spinal lesions in 21
consecutive patients were treated with radiosurgery technique ( 7 cervical,11
thoracic,4 lumber,and 2 sacral). There were 6 benign tumors and 18 malignant
lesions. All does plans were calculated on the basis of computed tomographic
images acquired from 1.25-mm slices with inverse treatment planning technique. Radiosurgical
circular cones ranging in diameter from 5 to 40 mm were used.

Results:

Tumor dose was maintained at 12 to 39Gy to 80% isdose line (mean,24Gy) and 1 to 5 fractioned. Canal volume receiving more than 8 Gy ranged from 0.0~1.23 cm3 (mean,0.2cm3). No acute radiation toxicity or new neurological deficits occurred during the follow-up period ( range,3~6mo;mean,4.3 mo.).Axial and radical pain fully improved in 11 of 13 patient and 2 partial improved than before treatment.

Conclusions: The major potential benefits of
radiosurgical ablation of spinal lesions are short treatment time in an
outpatient setting with rapid recovery and symptomatic response. This technique
offers a successful therapeutic modality for the treatment of a variety of
spinal lesions as a primary treatment or for lesions not amenable to open
surgical techniques, in medically inoperable patients,in lesions located in
previously irradiated sites, or as an adjunct to surgery.